Awareness of lung cancer screening among smokers: a Lebanese experience

Background: Lung cancer remains the leading cause of cancer-related mortality worldwide, largely due to late diagnosis, despite strong evidence that low-dose computed tomography (LDCT) reduces mortality and morbidity associated with lung cancer. The effectiveness of screening heavily relies on public awareness and participation. In Lebanon, where tobacco use is prevalent, and no national lung cancer screening program exists, data on LDCT awareness and uptake are limited. Objectives: This study aims, on one hand, to evaluate awareness and uptake of LDCT screening among Lebanese individuals at risk and, on the other hand, to identify factors associated with knowledge and screening behavior. Methods: A cross-sectional survey was conducted in Lebanon between December 1, 2024, and December 1, 2025, among current and former Lebanese smokers aged 40 years and older. A structured questionnaire was developed in both online and in-person forms, and collected information on sociodemographic characteristics, smoking history, awareness of LDCT screening, previous screening, and perceived barriers. Results: 242 eligible participants filled the questionnaire. Only 21.1% of participants reported prior knowledge of LDCT screening, and 9.9% had previously undergone screening. The strongest independent predictor of awareness was a higher educational level. LDCT uptake was strongly associated with prior knowledge of the test, male sex, higher socioeconomic status, and active smoking. The most commonly reported barriers included a lack of information and low perceived personal risk, particularly among former smokers. Conclusion: A significant gap was seen between the proven benefits of LDCT screening and its implementation in Lebanon. These findings highlight the need for education, centered on physicians, targeted public health campaigns, and the formation of a national lung cancer prevention strategy with LDCT to reduce avoidable morbidity and mortality.